Objective To analyze the use of spiral CT in the differential diagnosis of focal organizing pneumonia and peripheral lung cancer. Methods Methods: using the retrospective method, selects my courtyard from 2012 May -2013 year in October admitted 40 cases of focal organizing pneumonia patients as the observation group; at the same time, a total of 40 cases of peripheral lung cancer patients in our hospital as control group, compared two groups of spiral CT imaging features. Results The patients in the observation group spinous herniation, bow indentation sign, deep lobulation sign, air bronchogram, short spiculation, adjacent pleural thickening, liquefaction and necrosis, calcification and the lymph nodes the number of cases and control group had obvious difference(P<0.05), no significant differences compared to other symptoms (P>0.05); enhanced CT increase of mean value is greater than the control group (P<0.05), and the observation group patients the lesion site resides in the right upper lung (87.5%), the lesions were oval in shape (47.5%), the edge of a clear majority (62.50%). Conclusion Focal organizing pneumonia in imaging has certain features which can be shown by spiral CT, is conducive to the differential diagnosis to help with the surrounding lung cancer.